facility ased management of early growth failure
Post on 23-Feb-2022
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Facility Based Management of Early Growth Failure (In first 6 months of life)
• Period of high velocity of somatic and neural growth.
• Growth failure identified by regular growth monitoring as sub normal anthropometry.
Criteria for admission in facility
Too weak to suckle effectively
Weight static or gain subnormal
Weight loss
W/L <-3SD
W/A <-3SD
Bilateral pedal pitting nutritional edema
Compartments of facility
SNCU/Postnatal/Pediatric ward/HBNC
Should be continuum of care since birth
Approach to a case U6mo
Triage
History
Examination
Test/Imaging
Identify medical complication
Anthropometry/review of growth charts
Assessment of nutritional risk
Counsel Mother
Address her Medical/social/nutritional problems
Correct position, attachment
SST with EBM/Donor mother milk/infnatformula/F75/F100dil
Prospects of BF
Management of children less than 6 months of age
• WHO 10 steps and management of complications are same
Algorithm for deciding level of care of infants U6M
Cont..
Medical management and micronutrient supplementation
Medical management and micronutrient supplementation
Management of SAM < 6 months with prospect of breastfeeding
• Correct positioning and attachment
• SST with F100 diluted
Factors affecting milk production
Good and Poor Attachment
Position of the mother
Supplementary Suckling Technique (SST)
Regulating quantity of catch up diluted (F-100 d)
Management of SAM < 6 months without prospect of breastfeeding
• Stabilization phase (medical complication and edema): Start F75
• Rehabilitation phase ( if no complication and edema): Start
F100 diluted
• Initially 2 and then 3 hourly feed
Outcome
• Good weight gain ≥ 10g/kg/day
• Moderate weight gain 5g to 10g/kg/day
• Poor weight gain >5g/kg/day
• Failure to respond
– Failure to regain appetite after 4 days of admission
– Failure to begin to lose odema from 4th day
– Edema still present after 10 days
THANK YOU
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